181 articles - From Saturday Jan 08 2022 to Friday Jan 14 2022
| Am J Gastroenterol |
Acute-on-Chronic Liver Failure Clinical Guidelines. In instances where the evidence was not appropriate for Grading of Recommendations, Assessment, Development, and Evaluation, but there was consensus of significant clinical merit, key concept statements were developed using expert consensus. These guidelines are meant to be broadly applicable and should be viewed as the preferred, but not only, approach to clinical scenarios. |
| Gastrointest Endosc |
American Society for Gastrointestinal Endoscopy guideline on informed consent for GI endoscopic procedures. Because this document was designed by considering the laws and broad practice of endoscopy in the United States, legal requirements may differ by state and region, and it is the responsibility of the endoscopist, practice managers, and other healthcare organizations to be aware of local laws. Our recommendations are designed to improve the informed consent experience for both physicians and patients as they work together to diagnose and treat GI diseases with endoscopy. |
meta-analyses and systematic reviews
| Am J Gastroenterol |
P002 Psychiatric Comorbidity and Suicide in Childhood Onset Immune-Mediated Diseases -A Systematic Review and Meta-Analysis. In this systematic review, patients with childhood onset IMID had increased prevalence of psychiatric disorders compared to controls. However, only pooled estimates on emotional disorders were possible and studies investigating broad spectrum of psychiatric disorders are needed. |
P014 Postoperative Recurrence in Crohn's Disease Patients Treated with Adalimumab versus Infliximab: A Systematic Review and Meta-Analysis. Our meta-analysis demonstrated comparable efficacy of infliximab and adalimumab in maintaining post-operative clinical and endoscopic remission in Crohn's disease, with similar rates of adverse events. Our meta-analysis was limited by the small number of total studies and patients included and the lack of randomized controlled trials. |
P030 Chemokines and Adipokines As Biomarkers of Crohn's Disease Activity: A Systematic Review Of The Literature. Despite the limitations and the small number of studies found in the literature that followed the criteria of this SR, some chemokines (CCL2, CCL20, CXCL1, CXCL3, CXCL8, CXCL10 and CXCL1) and adipokines (leptin, IL-6 and TNF-a) have unveiled promising results that may enable us to distinguish active versus in remission forms of CD based on objective criteria of inflammation such as endoscopic, histologic or radiological criteria. The development of disease activity biomarkers for CD is becoming relevant for clinical practice, and chemokines and adipokines have the potential to signalize CD activity. However, validation in larger cohorts of patients, preferable multicenter studies are still needed. |
P077 Incidence of Colonic Strictures - A Systematic Review and Meta-analysis. This systematic review and meta-analysis on the incidence of colonic strictures in UC showed that the overall pooled incidence and 10-year incidence of colonic strictures in UC are low. There was a trend towards lower incidences of UC strictures in the post-biologic era, although the differences did not reach statistical significance. While the overall incidence of colonic strictures, in UC is low, a high proportion of colonic strictures are associated with HGD or CRC, even in the biologic era. Therefore, this study provides further support for importance of stricture biopsy and surgical evaluation for colectomy in the UC patient with colonic stricture. |
| Gastroenterology |
Twenty-first century trends in the global epidemiology of pediatric-onset inflammatory bowel disease: systematic review. Rates of pediatric-onset IBD continue to rise around the world and data are emerging from regions where it was not previously reported. However, there remains a paucity of data on VEO-IBD and on pediatric IBD from developing and recently developed countries. |
| Gut |
Efficacy of Helicobacter pylori eradication therapy for functional dyspepsia: updated systematic review and meta-analysis. Objective Functional dyspepsia (FD) is a chronic disorder that is difficult to treat. eradication therapy leads to both cure and improvement in FD symptoms, although the benefit is modest. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
A sequential approach using the age-adjusted fibrosis-4 index and vibration-controlled transient elastography to detect advanced fibrosis in Korean patients with non-alcoholic fatty liver disease. The sequential approach of age-adjusted FIB-4 and VCTE could represent a practical diagnostic strategy to detect advanced fibrosis in NAFLD (ClinicalTrials.gov #NCT02206841). |
NAFLD-related gene polymorphisms and all-cause and cause-specific mortality in an Asian population: the Shanghai Changfeng Study. A composite genetic-predisposition score of PNPLA3, TM6SF2, and MBOAT7 risk alleles presented similar opposite effects on liver-specific and cardiovascular mortality. Moreover, interactions of the NAFLD risk alleles with adiposity for liver-specific mortality were found (P T variants increase liver-specific mortality but reduce cardiovascular mortality in overweight/obese Chinese. |
Randomised clinical trial: a phase 1b study of GB004, an oral HIF-1a stabiliser, for treatment of ulcerative colitis. Results from this phase 1b trial support evaluation of the full therapeutic potential of GB004 for the treatment of UC. A phase 2 study (NCT04556383) is ongoing. Clinicaltrials.gov NCT03860896. |
| Am J Gastroenterol |
Climate Change and Gastroenterology: Planetary Primum Non Nocere and How Industry Must Help. At present, there are no clear guidelines or regulations on controlling healthcare-related industry emissions and improving sustainability. This narrative review aims to provide practical suggestions at each step of the supply chain can lead to greater sustainability. |
P001 Corticosteroid Induced Mood Changes in IBD. Patients with IBD and concurrent anxiety/depression experience improved IBD symptoms with antidepressant therapy. However, patients on antidepressants are more likely to experience neuropsychiatric adverse effects from corticosteroids such as hypomania, insomnia, and anxiety. Providers should be aware of the potential benefits and risks of prescribing antidepressants and corticosteroids in patients with IBD. Future research can clarify benefits and risks by investigating if corticosteroids are required less in IBD patients who take antidepressants. |
P003 Meat Consumption and All-Cause Mortality in 5763 Inflammatory Bowel Disease Patients: A Prospective Cohort Study. In this study, more frequent consumption of processed meat was found to be associated with the increased risk of mortality in IBD patients, while no such associations were observed in IBD patients who consuming fish, unprocessed poultry meat or unprocessed red meat. Therefore, based on the results above, we recommend a remodified diet with restricting processed meat as well as supplying an additional healthy diet for IBD patients, using alone or in combination with pharmacotherapy. |
P007 The Frequency of Anxiety and Depression in Patients With Inflammatory Bowel Diseases in the Moscow Clinical Scientific Center. The prevalence of anxiety and/or depression is 77% in patients with IBD during an exacerbation in the Moscow Clinical Scientific Center named after A. S. Loginov. |
P008 A Novel Smartphone Application to Reduce Infusion Suite Wait Times. In this pilot feasibility study, the Almost There app led to decreased perceived wait times for IBD patients coming for biologic infusions. The application was not effective for 18% of patients for a variety of reasons. If this or a similar app was improved to allow for more consistent usability it should be studied compared to a control group to evaluate if it leads to decreased wait times for any medical infusion. |
P009 Assessing the Status Quo: Ulcerative Colitis Monitoring in a Community GI Practice. Current guidelines offer recommendations on the use of PROs, biomarkers, and endoscopy in monitoring ulcerative colitis. This study highlights the presence of inconsistency in the use of these monitoring tools. When growing an IBD care center, it is necessary to identify strengths and weaknesses of the existing types and processes of care. When this care is not standardized, there in inevitably increased variability in provider care, as is evident by the results of this study. A well-defined methodology for monitoring patients with IBD should be defined and implemented to improve outcomes and stimulate growth in IBD care centers. |
P010 Precision Dosing Tool Forecasts Trough Infliximab and Associates With Disease Status in Inflammatory Bowel Diseases. These data establish the value of our MIPD tool in forecasting trough IFX levels in patients with IBD. Serum TNF-a and CRP are reflective of inflammatory burden which impacts exposure. |
P011 Prevalence of Cannabis Use Disorder in Inflammatory Bowel Disease Hospitalizations in the United States and Effect on Length of Stay. Young age, male sex, African American race, and Crohn's disease were positively associated with cannabis use disorder in IBD hospitalizations. There was no effect of cannabis use disorder on length of stay. |
P012 Efficacy of Exclusive Enteral Nutrition and Weekly Adalimumab Combination in Crohn's Patients With Fibroinflammatory Stenosis. Despite the extremely limited number of patients and short-term follow-up results, 12-week EEN and concurrent weekly ADA therapy may be effective in inducing remission in this group of patients. There is a need for large-scale, prospective studies on this subject. |
P013 Resolution of Infliximab Associated Infusion Hypersensitivity After Switching to Biosimilar Infliximab-dyyb. Immediate IR reactions have been reported in 5-23% of IBD patients receiving infliximab and those who develop antibodies towards infliximab have a 2-fold risk of acute IR events. Side effects have been reported to be the primary reason for discontinuation of infliximab, and studies have shown that discontinuation can lead to an increased risk of relapse of inflammatory bowel disease. Although infliximab and infliximab-dyyb have analogous active ingredients, the inactive ingredients differ. Specifically, infliximab-dyyb lacks monobasic sodium phosphate and dibasic sodium phosphate, which acts as an emulsifier which we believe contributed to her IR with originator biologic infliximab. It is important to recognize these differences as IR hypersensitivities may be attributed to inactive ingredients; especially when antibodies are negative. Our case report suggests that a switch to biosimilar infliximab in patients may provide added benefit especially in those that have reactions occurring from inactive ingredients in the originator biologic. |
P015 Impact of IBD on Daily Lives: A Descriptive Insight to Patient's Experience in the Work and Study Settings. Absenteeism is a significant factor affecting productivity in patients with IBD. Perception of disability may also impact work and study experiences. Raising awareness is essential for patient support in these settings. |
P016 Impact of Non-Remission on Health-Related Quality of Life and Patient Reported Outcomes in Patients With Crohn's Disease: Targeted Literature Review. This targeted review found in general that not being able to achieve/maintain remission had an impact on the HRQoL of patients with CD. Patients not achieving remission were associated with decreased work productivity, poor sleep quality, lower sleep efficiency, daytime sleepiness and poor HRQoL. However, studies assessing HRQoL and PROs in the real-world are scarce, with discrepancies based on remission status. Further research is warranted, and health care providers and payers should consider the impact of therapies on the improvement in HRQoL of patients with CD. |
P017 Increased Level of Immunoglobulin G in the Development of Adverse Reactions in Patients With Ulcerative Colitis. AR on the background of therapy with IFL and biosimilars are not associated with an increase in the level of IgE, but are caused by an increase in the level of IgG. The alternation of the original drug and the biosimilar increases the risk of developing AR due to increased IgG levels. Treatment with a biosimilar by one trade name does not increase the risk of developing AR. |
P018 How to Improve Transition of Pediatric IBD Patients Through Use of EMR. Adult and Pediatric Gastroenterologists al agree that effective transition of IBD care is critical to the patient's well-being. However, adult and pediatric providers may have differing views of the importance of certain aspects of the psychosocial and preventative care components of IBD management. In our institution, we are able to provide IBD care to patients for their entire life span. To the benefit of patients, this is becoming more common at academic centers, making the use of a universal IBD template critical for excellent continuity of care. As a result of our inter-departmental meetings, we were able to learn why different aspects mattered at different stages of a patient's life. This allowed us to create a flexible template to incorporate these changing priorities. We believe that our current IBD progress note is a functional mesh of those factors and is less cumbersome than a separate template required by adult providers. Most importantly, it presents a united front, and demonstrates to patients that their care is a continuum within our institution. |
P019 Not All Fecal Calprotectin is Specific for Inflammatory Bowel Disease. We present here a case where a common cancer was found in an otherwise healthy, young male with acute abdominal pain and altered bowel habits. While initial symptoms, imaging and laboratory findings pointed towards a biased high suspicion for Inflammatory Bowel Disease, patient's ultimate diagnosis was stage 3 adenocarcinoma of colon requiring surgical resection and chemotherapy. Fecal calprotectin is a known marker for colon inflammation and associated with both IBD and colon cancer. It is important to keep in mind that while fecal calprotectin may have elevated negative predictive value and be used to rule out organic disease, elevation of fecal calprotectin is not always specific for IBD. We want to emphasize the importance of considering colon cancer on the differential despite a patient's age and diagnostic bias. Lastly, we also want to highlight the importance of tissue diagnosis prior to long term therapy use. |
P020 Proton Pump Inhibitor Therapy: Providing "Acid" Outcomes in Patients With Inflammatory Bowel Disease Under Infliximab Treatment. Despite not conducting to significantly different deep remission rates, concomitant PPI therapy was associated with a three-fold increase in hospitalization rates in IBD patients under infliximab treatment, even when adjusted for classical risk factors for adverse outcomes in IBD. These findings emphasize the importance of restricting PPI treatment to those with a clear clinical indication, especially in this set of patients. |
P022 Biologic Therapy and Therapeutic Drug Monitoring in Patients With Inflammatory Bowel Disease and Primary Sclerosing Cholangitis. Herein we describe epidemiologic data of biologic use in PSC-IBD patients at an academic center. PSC-IBD classically follows a less severe clinical presentation and course. However, our study demonstrates that a subset of PSC-IBD patients exist which require biologic therapy and follow a more refractory clinical trajectory. In this subset, TDM showed a high incidence of sub-therapeutic trough levels and anti-drug antibodies, leading to a change in therapy in 85% of TDM instances. Larger studies are recommended to better understand this unique subset of PSC-IBD patients. |
P023 Parental Distress in Pediatric Inflammatory Bowel Disease. In this cohort, we found that a majority of parents with children with IBD had clinically elevated anxiety scores with no significant decrease in mean transformed scores over time. The only measure of distress that did significantly reduce between cohorts was the mean transformed IES-R score. In conclusion, the present study suggests considerable parental distress in parents of children with IBD. Interventions to alleviate parental distress might be considered. |
P024 Anorectal Manometry in Patients with Fecal Incontinence After Ileal Pouch-Anal Anastomosis for Inflammatory Bowel Disease: A Cohort Study. Overall, anorectal pressures and sensation are similar between IPAA-FI and non-IBD-FI patients. However, the underlying FI mechanism seems to differ. Higher rates of urinary incontinence in the non-IBD-FI cohort suggests global pelvic floor dysfunction compared to IPAA-FI patients who are younger and have post-operative neuromuscular dysfunction, as evidenced by shorter sphincter length and absent RAIR. Though rectal hypersensitivity and lower squeeze/push pressures are observed in both patient groups compared to healthy controls, normal resting pressure in IPAA-FI suggests that potentially different normative ranges are needed for this cohort to accurately assess post-surgical changes and guide pre-operative counseling. |
P025 The Impact of Non-Remission on Costs and Resource Use In Patients With Crohn's Disease: Targeted Literature Review. This targeted review found in general that not being able to achieve/maintain remission has an impact on the economic outcomes of patients with CD. Non-remission in patients with CD was associated with an increased number of hospitalizations and surgeries. The cost of treatment for non-remitters was significantly higher than patients in remission. None of the studies presented data for patients who respond to treatment but are not able to achieve remission. Further research is warranted in these patients. |
P027 Brain Fog in Patients With Inflammatory Bowel Disease, and Association With Use of Probiotics. Consumption of probiotics was independently associated with brain fog in men, as well as Caucasian patients with IBD respectively. Given the high prevalence of probiotic use in IBD patients, prospective studies are warranted to examine the causal relationship between probiotics and IBD-associated brain fog to guide prescription of probiotic supplements for IBD. |
P028 Communicating Needs and Features of IBD Experiences (CONFIDE) Survey: Patient and Healthcare Professional Perspectives on Experience of Ulcerative Colitis Symptoms. Bowel urgency is the second-most commonly reported symptom by patients with moderate-to-severe UC but is not among the HCP-perceived top three most reported symptoms. A substantial proportion of patients with moderate-to-severe UC receiving advanced therapies continue to report bowel urgency. A communication gap between patients and HCPs was identified and highlights the under appreciation of bowel urgency as an important symptom impacting patients' daily life. |
P029 Pharmacokinetic/Pharmacodynamic Analysis of Amiselimod, a Selective Sphingosine 1-Phosphate Receptor Modulator, in Healthy Subjects: Results From a Phase 1 Study. The abbreviated amiselimod dosing titration regimen reached steady state within 14 days for the therapeutic 0.4 mg QD regimen and within 26 days for the supratherapeutic 0.8 mg QD regimen; expected decreases in ALCs were observed following amiselimod. |
P031 Impact of Prior Biologic Exposure on Response to Ozanimod for Moderate-to-Severe Ulcerative Colitis in the Phase 3 True North Study. Ozanimod improved clinical, endoscopic, and histologic outcomes in both biologic-exposed and -naïve patients. Patients with prior biologic use may require additional time to respond to treatment. Outcomes were improved with ozanimod regardless of prior use of anti-TNF agents and vedolizumab. |
P032 Clinical Usefulness of Double Balloon Enteroscopy in Patients With Established or Suspected Small Bowel Crohn's Disease. DBE is a useful technique to confirm a diagnosis in patients who have suspected CD and can help establish a diagnosis of several diseases that may mimic CD on CT scan or CE. Additionally, DBE in patients with established diagnosis of small bowel CD is an effective tool to assess disease activity and guide therapy. Serious complications are infrequent. |
P033 Moving the Needle on Speaker Diversity at AIBD. From 2014-2020, the proportion of female speakers at AIBD has increased to over one third in main programming. There remains room for improvement, particularly in increasing the racial and ethnic diversity of speakers and inviting more gastroenterologists in the early stages of their careers. |
P035 Ozanimod for Moderate-to-Severe Ulcerative Colitis: North American Population Results During Induction and Maintenance in the Phase 3 True North Study. In this post-hoc analysis, consistent with the global population, ozanimod treatment for up to 52 weeks in North American patients with moderately-to-severely active UC showed benefits on clinical and endoscopic endpoints. |
P036 Disparities in Diagnosis and Management of Patients with Crohn's Perianal Fistulas: Results of a US National Patient and Caregiver Survey. Disparities in diagnosis and management of CPF exist between non-white and white patients/caregivers, including length of time to diagnosis, perceptions of quality of care and barriers to treatment. Further research into disparities in the management of CPF is needed, as is CPF education for patients/caregivers and HCP education on managing CPF in minority populations. |
P037 Effect of Ozanimod Treatment and Discontinuation on Absolute Lymphocyte Count in Moderate-to-Severe Ulcerative Colitis: Results from a Phase 3 Trial. Consistent with the mechanism of action of ozanimod, ALC reductions occurred during ozanimod induction and were sustained during maintenance. Incidence of ALC 9/L was low. ALC recovered after switching to placebo and most patients did not require treatment discontinuation because of changes in ALC. |
P038 Ozanimod First-Dose Cardiac Effects in Patients with Moderately to Severely Active Ulcerative Colitis and Relapsing Multiple Sclerosis. In clinical trials of ozanimod, the number of patients with UC or MS who failed screening because of exclusionary cardiac disorders was low. Most patients with a history of cardiac disorders who were enrolled in ozanimod clinical trials did not have Day 1 cardiac events, and the events that occurred were manageable. |
P040 Latent Tuberculosis Infection In A Patient With A Negative Interferon Gamma Release Assay Prior to Biologic Initiation for Crohn's Disease. In cases of high suspicion, imaging with plain radiograph or CT scan is a useful tool in supporting the diagnosis of LTBI and may show predominantly upper lobe cavitary disease. Biologic therapy for IBD should be deferred until at least one month of treatment for LTBI has been completed. |
P041 Successful Reduction in Opioid Prescription for IBD Flare in the Emergency Department: A Retrospective Study and Quality Improvement Initiative. Almost 80% of patients who present to ED with IBD flare are prescribed opioids, while only half of patients receive non-opioid analgesics. Also concerning was the high rate of opioid prescription at ED or hospital discharge. A multimodal intervention successfully reduced the proportion and amount of opioid prescribing in the ED without compromising pain control or increasing the risk of GI bleeding. This was also associated with a significant increase in a non-opioid analgesic administration and a significant decrease in GI service consultation. These findings support the role of implementing an evidence-based IBD pain management guideline with electronic prescribing support and education in the ED setting for acute IBD flares. Additional research is needed to determine long-term benefits of reduced opioid exposure in this population. |
P042 Early Versus Later Use of Vedolizumab In IBD: Patient Characteristics And Treatment Patterns In The Real World (RALEE). In this administrative real-world dataset, fewer than 10% of patients with IBD were treated with VDZ within 30 days of diagnosis, and these patients were more likely to be younger and women. These findings are distinct from guidelines suggesting VDZ may be used earlier, or due to its safety profile, preferentially in older patients at higher risk for infection. Further analyses of safety and effectiveness outcomes are underway. |
P043 Resource Utilization and Productivity Loss among Patients with Inflammatory Bowel Disease in Sweden: A Longitudinal Nationwide Population-based Study. Findings from this study of a large national cohort of patients followed for many years demonstrates the significant epidemiological, clinical, and socioeconomic impact of patients with CD and UC. Further research is needed to understand underlying factors driving inpatient admissions among patients with IBD. With an increasing annual prevalence, IBD continues to impose a substantial public health burden to patients, their families and health care services. |
P044 A Profile of New Start IBD Patients on Multiple Advanced/Biologic Therapies. A profile of new start biologic IBD patients ideal for concomitant advanced therapy emerged when reviewing almost 1,000 physician-reported patient records. These patients are more likely to have had gastroduodenal Crohn's disease and or recent bowel perforation or re-section. These patients are more likely to report impaired work performance, chronic fatigue, more frequent ER visits and more frequent hospitalizations. |
P045 Prevalence of non-alcoholic fatty liver disease (NAFLD) in patients with inflammatory bowel disease (IBD) in a Brazilian public healthcare clinic. Development of NAFLD is a frequent occurrence in patients with IBD. NAFLD group had higher levels of body mass index, C-reactive protein, AST, ALT, fasting glucose and blood insulin, which are also associated with metabolic syndrome. Early diagnosis and appropriate nutritional orientation are necessary to prevent NAFLD related complications. |
P046 Tofacitinib Induced Resolution of Severe Colitis and Reactive Atypia in an Adolescent Patient With IBD. She underwent repeat colonoscopy with chromoendoscopy 5 months after initiation of tofacitinib which revealed mild acute ileitis but no active colonic inflammation, atypia or dysplasia. This is the first report to our knowledge that an adolescent patient with colonic predominant Crohn's disease has complete resolution of atypia and possible early dysplasia with tofacitinib therapy. |
P047 The Crohn's Disease-Health Index (CD-HI): Development and Validation of a Novel, Disease-Specific Patient Reported Outcome Measure for Clinical Trials. This research successfully demonstrates the ability of the CD-HI to report valid, reliable, and patient-relevant data as a disease-specific PROM. The CD-HI provides researchers and clinicians with an optimal mechanism to record relevant changes in CD health using the patient's perspective. |
P048 Metastatic Crohn's Disease Debuting with Severe Oral Manifestation and Vulvar Involvement - A Diagnostic Challenge. MCD represents a diagnostic challenge, it can debut without gastrointestinal involvement, and its clinical and histopathological findings simulate other entities. A timely diagnosis is required to seek early benefit in the patient. |
P050 Oral Inflammatory Changes Associated With Inflammatory Bowel Disease in Spondyloarthritis Associated With Early Endoscopic Findings. Patients with SpA without a diagnosis of IBD have more oral signs and symptoms compared to healthy controls. Gingivitis is important given its association with early endoscopic and histological findings. Manifestations in the oral cavity can precede intestinal manifestations, therefore the clinical assessment by the oral pathologist in conjunction with gastroenterology and rheumatology allows a timely referral to gastroenterology and an endoscopic and histological evaluation, impacting the quality of life of patients. |
P051 Identifying High-Risk Patients With Acute Severe Ulcerative Colitis: Is the ACE Index Useful? The ACE index is an accurate predictor of steroids response on admission in ASUC. However, in our study, the ACE index doesn´t discriminate whose high-risk patients would benefit from earlier therapeutic escalation, since only 50.0% of patients with an index of 3 did not respond to steroids. |
P052 National Registration of Patients With Inflammatory Bowel Disease in Brazil on Behalf of GEDIIB. To date, there is no IBD epidemiologic study covering the entire Brazilian territory. The results found with the registry will be fundamental to show the epidemiology of a country with continental dimensions such as Brazil. The greater the number of researchers included and from different regions of the country, the greater the representativeness of the data and may even help direct government actions on behalf of IBD patients. |
P053 Interstitial Nephritis from IBD: Complicated Conclusions. In al three cases, neither nephrology consultation nor renal biopsy helped distinguish the etiology of renal injury, defaulting to either the IBD meds or an extra-intestinal manifestation of IBD, and not accounting for the acute inflammatory symptoms in two of the cases. While literature review reveals several cases that allege kidney injury as an extra-intestinal target of IBD serious doubts remain. TIN secondary to aminosalicylates is well-documented, but there are few reports of adalimumab-induced granulomatous TIN and only one report of vedolizumab-induced TIN. Each of our patients had well-controlled IBD and multiple confounding variables that could impact kidney function or cause TIN, including hypertension and multiple potential culprit medications, illustrating the dilemma of determining the etiology of renal injury in IBD patients. |
P055 Sociodemographic Differences in Fecal Enteropathogen Testing Patterns in Adults Hospitalized for Inflammatory Bowel Disease Flares. Racial/ethnic (Hispanic vs non-Hispanic White) and healthcare settings (county vs tertiary referral teaching hospital) differences in enteropathogen testing patterns were observed in adults with IBD hospitalized primarily for GI symptoms at the state of Rhode Island's largest healthcare system. Further studies to assess health inequities, including sociodemographic and organizational differences, in the healthcare delivery in IBD are warranted. |
P056 Real life experience with the use of tofacitinib in ulcerative colitis in Colombia: case series. The results of this case report suggest that tofacitinib may be an effective therapeutic alternative in patients with moderate to severe UC and associated extraintestinal manifestations, with a good safety profile. |
P057 How Distance Between Residence and Treatment Center Impact the Outcome of Patients With Inflammatory Bowel Disease at CMN 20. We observed an impact between the distance of residence and specialized treatment center over the patient's clinical outcome. More readmissions, greater disease activity scores, more use of biological therapy and surgery were observed in patients who had to travel more than 750km from their home to their specialized treatment center compared to the other travel quartiles, this with a p = 0.0047. |
P059 Impact of PHQ-9 Screen on Early Identification of Depression in IBD Clinic. Key findings including identification of depression is higher in the intervention group compared to the control group. Though the data is not statistically significant, this is likely secondary to the small sample size in the setting of the pandemic. In addition, univariate analysis revealed a statistically significant finding that the older the age of the patient, the less likely they are to have depression. Our data showed that the mean age of depressed patients was 38.3 compared to nondepressed patients whose mean age is 47.1. Further analysis can help elucidate this finding, for example identifying if older patients are being treated for depression or more likely to seek out therapists compared to younger patients. Univariate analysis also revealed that intestinal Crohn's disease was a risk factor for depression. This is possibly secondary to the severity of disease in these individuals, especially if their IBD is causing an impact on their quality of life. Looking into the number of hospitalizations, days off from work or school, and coexisting medical diagnoses can allow us to further understand if depression stems from their disease. Given preliminary findings, we plan to continue this study for a larger sample size and further determine if there is a significant delay in identifying depression with the current standard of care. |
P060 Screening Criteria of Inflammatory Bowel Disease: Application in Colombian Patients With Spondyloarthritis. We found a high frequency of major and minor symptoms of IBD, both of which were associated with a high activity of spondyloarthritis and an important functional compromise as well as inflammation markers in this group of patients. The application of the screening criteria for IBD in SpA without IBD reflects a high frequency of intestinal symptoms of sufficient intensity that affect quality of life and disease activity. Early detection of gastrointestinal compromise allows patients to benefit from comprehensive treatment of the disease in its initial stages. |
P061 Impact of Inflammatory Bowel Disease on sleep quality in a Mexican population attended in a referral center. In this study a statistically significant association was obtained between PSQI and the perception of sleep reported by the patients, with a p < 0.005. Further research is still needed to better characterize sleep disturbances in this population. Due to the sample size, a prospective, randomized study is required to confirm these findings. The present analysis has no conflict of interest. |
P062 Chromoendoscopy With Magnification Colonoscopy: Analysis of Mucosa of Colon And Ileum In Patients With Gastrointestinal Symptoms Without IBD. Chromoendoscopy provided an enhanced, detailed contrast of the gastrointestinal mucosa surface, mainly in the loss of vascular pattern in ileum. The active search for symptoms, signs, and biomarkers of gastrointestinal involvement in addition to an objective endoscopic and histological evaluation may offer new perspectives at the evaluation of SpA patients and may provide guidance for specific clinical and therapeutic management. |
P063 Prevalence in the Use of Complementary/Alternative Medicine in Patients With Inflammatory Bowel Disease from Centro Médico Nacional 20 de Noviembre. Exposure to CAM for IBD treatment had a prevalence of 27%. The main CAM modalities for IBD patients were acupuncture, herbal, and homeopathy. No relationship was demonstrated between the use of CAM in IBD patients and their clinical outcomes. |
P064 Association Between Crohn's Disease (CD) and Transient IgM and IgG Immunodeficiency-Diagnostic and Management Challenges. We present a case report of the initial presentation of DC complicated with severe malnutrition where there was depletion of part of immunoglobulins, resulting in infectious and non-infectious complications, where ileal involvement intensified the manifestation of colonic DC. |
P065 A One-Time Education for Gastroenterologists Regarding Osteoporosis Screening for IBD Patients Improves Provider Knowledge But Not Screening Rates. DEXA scanning can help detect premature decrease in bone mineral density and provide physicians with the opportunity to prevent further morbidity. Our study showed no difference in DEXA screening rates before and after intervention. However, there was an increase in provider knowledge based on post-intervention surveys. A similar study showed that it took three interventions, including educational presentation, flyers, and on screen EMR reminders for there to be a sustainable improvement in the rate of DEXA screening. Our project may have required additional interventions to produce an effect and thus reinforces the need for further efforts to improve osteoporosis screening in IBD patients. |
P066 Real-World Experience of Ustekinumab in Crohn's Disease Patients With Prior Anti-TNF Therapy at a Tertiary Care Hospital. Our study demonstrates that remission rates in CD patients who have failed prior anti-TNF therapy are high, including for patients with perianal disease. In patients with fistulizing CD, we suggest using UST for higher rates of remission after induction. We also found that for fecal calprotectin, although an excellent surrogate of colon inflammation, compliance amongst patients remains low. |
P067 Immune Checkpoint Inhibitor Colitis in a Community-Based Hospital System. As immune checkpoint inhibitors gain approval in more cancer treatment ICI-colitis is being seen in a community-based setting. The most common treatment were steroids and often required a prolonged course. Biologic use in our series (18.9%) was much lower than prior reports from academic tertiary referral centers (>50%). Only 64.8% of patients saw a gastroenterologist for ICI-colitis symptoms. Early gastroenterology referral in the community setting could help to identify more severe disease and patients necessitating escalation to biologic therapy. |
P068 Racial and Socioeconomic Disparities in Acute Care Utilization in a National Cohort of Veterans With IBD. In this analysis of a large national outpatient cohort of patients with IBD, we identified significant racial differences in IBD disease behavior, anemia and subsequent acute care utilization. Racial differences in hospitalization were not significant after controlling for modifiable IBD risk factors suggesting actionable targets to mitigate the observed disparities. However, Black race was independently associated with ED utilization even in a healthcare system where access to care is theoretically similar. Future studies should investigate factors underlying increased ED utilization among Black IBD patients in further detail. |
P070 Next Generation Wearable Technology for IBD Patients: A Feasibility Study. Remote physiologic monitoring is a feasible way to give patients ownership of their medical care and involve them in the diagnostic and treatment process of their underlying IBD. As exhibited with our preliminary results, the Whoop device appears easy to use and may empower patients to reach out to providers even before symptoms occur, leading to an expedited evaluation for increased disease activity. Our feasibility study will hopefully lead to larger prospective efforts utilizing wearable technology devices such as the Whoop in IBD patients. |
P072 Non-invasive Vagal Nerve Stimulation to Treat Crohn Disease and Ulcerative Colitis in Children and Young Adults: A Proof-of-Concept Clinical Trial. Non-invasive ta-VNS reduced FC levels and improved symptoms in a pediatric cohort with mild/moderate IBD. Further research is needed to identify optimal electrical dose and settings to achieve peak anti-inflammatory effect and to identify the mechanistic principles for this therapy. |
P073 Diagnostic Outcome of Patients With Non-Specific Colitis. All patients with a histopathological diagnosis of non-specific colitis underwent a second colonoscopy with biopsy, which resulted in a definitive diagnosis of Crohn's disease in 5.6% of women and Ulcerative Colitis in 16.7% of men. This study comes to show that there is an important subgroup of patients who are underdiagnosed. We suggest that patients with non-specific colitis reported on a histopathology report must continue their follow-up by a specialized ward. |
P074 Comparative Risk of Clostridioides Difficile Infection in Vedolizumab vs anti-TNFa Agents in Biologic-Naïve Patients With Ulcerative Colitis. Our study did not identify an increased risk of CDI associated with vedolizumab vs anti-TNFa agents after controlling for UC severity. We hope that these findings will reassure UC providers considering vedolizumab as a first-line biologic agent in the context of gastrointestinal infectious risks. |
P075 Urgency and its Association with Quality of Life and Clinical Outcomes in Ulcerative Colitis Patients. We demonstrate that urgency is a PRO independently associated with compromised QoL in patients with UC. Urgency is associated with future risk of hospitalizations, steroid prescription, and colectomy. Our findings support the consideration of urgency as a UC-specific PRO and its use as an outcome in clinical trials to capture QoL and risk of clinical decompensation. |
P076 The Role of Dual Biologic Therapy in Inflammatory Bowel Disease. Dual biologic therapy can be used with improvement in symptomatic and endoscopic findings of IBD. The combination use of two biologic agents does not appear to have additional infectious risk compared to single agent and no other adverse events were described. Longer follow-up and larger patient populations are needed to verify the combination of biologic mechanisms for therapy of refractory IBD and EIMs. |
| Clin Gastroenterol Hepatol |
Fenofibrate Mitigates Hypertriglyceridemia in Nonalcoholic Steatohepatitis Patients Treated With Cilofexor/Firsocostat. In patients with NASH with hypertriglyceridemia treated with CILO and FIR, fenofibrate was safe and effectively mitigated increases in triglycerides associated with acetyl-CoA carboxylase inhibition. ClinicalTrials.gov, Number NCT02781584. |
Prevalence and Implications of Frailty in Older Adults with Incident Inflammatory Bowel Diseases: a Nationwide Cohort Study. Frailty is more prevalent in older adults with IBD than matched comparators. Among older patients with IBD, frailty is associated with increased risk for hospitalizations and mortality. |
QuickStroop, a Shortened Version of EncephalApp, Detects Covert Hepatic Encephalopathy with Similar Accuracy within One Minute. QuickStroop, which is completed within 1 minute, gives an equivalent ability to predict CHE on the gold standard compared to the entire EncephalApp time. |
| Endoscopy |
Complete Polyp Resection with Cold versus Hot snare Polypectomy for Polyps sized 4-9 mm: A randomized controlled trial. In this randomized trial, non-inferiority for cold snare polypectomy could not be demonstrated. Polyps with serrated histology are more prone to incomplete resection compared to adenomas. Cold snare polypectomy for small polyps can be used safely in routine colonoscopy practise. |
| Gastroenterology |
Artificial Intelligence for Disease Assessment in IBD: How Will it Change Our Practice? Applications of AI in IBD will cover recent achievements in endoscopic image interpretation and scoring, new capabilities for cross-sectional image analysis, natural language processing for automated understanding of clinical text, and progress in AI-powered clinical decision support tools. In addition to detailing current evidence supporting the capabilities of AI for replicating expert clinical judgement, speculative commentary on how AI may advance concepts of disease activity assessment, care pathways, and pathophysiologic mechanisms of IBD will be addressed. |
Breaking through the therapeutic ceiling: what will it take? These range from improved early diagnosis and initial management, through better treatment stratification and response monitoring, to improvements in clinical trial design and selection of drugs in combination therapies. In this article we discuss the steps required in al of these areas, in order to make best use of new therapeutic options and shatter the glass ceiling. |
Colorectal cancer screening in IBD - can characterization of GI microbiome signatures enhance neoplasia detection? Here we discuss the utility of the stool microbiome as a non-invasive CRC screening tool. Comparing the performance of multiple microbiome-based CRC classifiers, including several multi-cohort meta-analyses, we find that non-invasive detection of colorectal adenomas and carcinomas from microbial biomarkers is an active area of study with promising early results. |
Evolving short- and long-term goals of management of IBD: getting it right, making it last. The SPIRIT consensus defines the targets for these trials to assess the long-term impact of early treatment on quality of life, disability, disease complications, risk of neoplastic lesions and mortality. As further data emerge about the risk-benefit balance of aiming toward deeper healing, the targets in treating IBD may continue to shift. |
How do we predict a patient's disease course and whether they will respond to specific treatments? The growing therapeutic armamentarium will only make these decisions more difficult, and yet we have seen how other specialties have begun to use the molecular heterogeneity in their diseases to provide some answers. In this article, we review the progress that has been made in predicting the future for any given IBD patient - whether that is the course of disease that they will experience or whether or not they will respond to, or indeed tolerate, a particular therapy. |
How should pain, fatigue and emotional wellness be incorporated into treatment goals for optimal management of IBD? This review will highlight the burden of these symptoms and issues; suggest ways of assessing these in clinical practice; highlight the importance of acknowledging and validating the symptoms and issues with patients, reassuring them that they are being heard; and discuss different possible models of service delivery for psycho-social support, from fully integrated gastropsychology models to referral pathways that optimize community support. We suggest the importance of the treat to target concept, where the target is not only control of inflammation, but also emotional wellness. |
Inhibition of Viral Replication Reduces Transcriptionally Active Distinct Hepatitis B Virus Integrations with Implications on Host Gene Dysregulation. Inhibition of viral replication reduces the number of transcriptionally active distinct HBV-host DNA integrations in patients with substantial viremia. Given the mutagenic potentials of viral integrations, such treatment effects should be considered in patient management. |
Off-the-shelf PSCA-directed chimeric antigen receptor natural killer cell therapy to treat pancreatic cancer. PSCA CAR_s15 NK cells showed therapeutic efficacy in human metastatic PC models without signs of systematic toxicity, providing a strong rationale to support clinical development. |
Point-of-care testing and home testing: pragmatic considerations for widespread incorporation: stool tests, serum tests, intestinal ultrasound. Combining intestinal ultrasound during a clinic visit with existing serum and stool biomarkers in a home testing setup with electronic health monitoring allows for an optimized, patient-centered personalized treatment algorithm that may improve treatment outcomes. Here, we review the current state, pragmatic considerations, and future implications of point-of-care testing and home testing for non-invasive inflammatory bowel disease monitoring in the tight control model. |
Prevalence and Predictors of Young-Onset Colorectal Neoplasia: Insights from a Nationally Representative Colonoscopy Registry. These data provide support for lowering the screening age to 45 for al average risk individuals. Early messaging to patients and providers in the years leading up to age 45 is warranted, especially in those with a family history of CRC. |
The future of precision medicine to predict outcomes and control tissue remodeling in inflammatory bowel disease. Crucially, the international community has collective responsibility to provide well-phenotyped and curated, longitudinal datasets for scientific discovery and validation. Research must also study broader aspects of the immune response including components of the extracellular matrix to better understand biological pathways initiating and perpetuating tissue fibrosis and longer-term disease complications. |
Time to revisit disease classification in IBD: is the current classification of IBD good enough for optimal clinical management? Although these revised classification tools alone will not be sufficient and should be complemented by more detailed molecular subclassifications, optimised clinical phenotypes can contribute to improved trial designs, future translational research approaches and better treatment outcomes. In the current review, we discuss key clinical features important in IBD disease heterogeneity, tackle limitations of the current classification systems, propose some potential improvements and raise priorities for future research in this domain. |
| Gastrointest Endosc |
Cost utility analysis of strategies for minimizing risk of duodenoscope related infections. Our model indicates that PD represent the option most favorable from a cost utility standpoint for ERCP, with anticipated very low infection transmission rate and a low-cost disposable element. These data underscore the importance of cost calculations which account for the potential for infection transmission and associated patient morbidity/mortality. |
EUS-guided choledochoduodenostomy for malignant distal biliary obstruction after failed ERCP: a retrospective nationwide analysis. The results of our study show that EUS-CDS with LAMS in case of DMBO in patients with failed ERCP represents a viable alternative in terms of effectiveness and safety with acceptable AE rates. |
External validation of a model determining risk of neoplastic progression of Barrett's esophagus in a cohort of United States veterans. This external validation provides further evidence that the model including sex, LGD status, smoking status, and BE length may help to risk stratify BE patients. A simplified version excluding LGD status and/or reducing the number of risk groups has increased utility in clinical practice without loss of discriminatory ability. |
Machine learning-based personalised prediction of gastric cancer incidence using the endoscopic and histological findings at the initial endoscopy. We developed a novel ML model that incorporates endoscopic and histological findings at initial EGD for personalized risk prediction of gastric cancer. This model may lead to the development of effective and personalized follow-up strategies after initial EGD. |
Novel endoscopic tangential sawing technique in treatment of giant gastric bezoars: a retrospective single-center study (with videos). GTSF technique is a safe, effective, and feasible method for removing giant bezoars, and can be considered as an alternative treatment of this disease. |
| Gut |
Blocking hepatocarcinogenesis by a cytochrome P450 family member with female-preferential expression. The liver-specific CYP39A1 with female-preferential expression was a strong suppressor of HCC development. Strategies to up-regulate CYP39A1 might be promising methods for HCC treatment in both women and men in future. |
CCT3-LINC00326 axis regulates hepatocarcinogenic lipid metabolism. We revealed that RBP gene expression is perturbed in HCC and identified that RBPs exerted additional functions beyond their tasks under normal physiological conditions, which can be stimulated or intensified via lncRNAs and affected tumour growth. |
Clinical, histological and molecular profiling of different stages of alcohol-related liver disease. Despite comparable alcohol intake, AH patients presented with worse liver function compared with ndALD patients. Bilirubinostasis, severe fibrosis and ductular reaction were prominent features of AH. AH patients exhibited a more profound deregulation of gene expression compared with ndALD patients. |
Extracellular Vesicles from Pancreatic Cancer Stem Cells Lead an Intratumor Communication Network (EVNet) to fuel tumour progression. PDAC tumours establish a cooperation network mediated by EVs that is led by CSC and agrin, which allows tumours to adapt and thrive. Targeting agrin could make targeted therapy possible for patients with PDAC and has a significant impact on CSC that feeds the tumour and is at the centre of therapy resistance. |
Gut microbiota regulate Alzheimer's disease pathologies and cognitive disorders via PUFA-associated neuroinflammation. These findings support that a complex gut microbiome is required for behavioural defects, microglia activation and AD pathologies, the gut microbiome contributes to pathologies in an AD mouse model and that dysbiosis of the human microbiome might be a risk factor for AD. |
Impairment of gut microbial biotin metabolism and host biotin status in severe obesity: effect of biotin and prebiotic supplementation on improved metabolism. Strategies combining biotin and prebiotic supplementation could help prevent the deterioration of metabolic states in severe obesity. Trial registration number NCT02059538. |
Mapping the human gut mycobiome in middle-aged and elderly adults: multiomics insights and implications for host metabolic health. We depict the sociodemographic and dietary determinants of human gut mycobiome in middle-aged and elderly individuals, and further reveal that the gut mycobiome may be closely associated with the host metabolic health through regulating gut bacterial functions and metabolites. |
Reprogramming the spleen into a functioning 'liver' in vivo. Direct conversion of the spleen into a liver-like organ, without cell or tissue transplantation, establishes fundamental hepatic functions in mice, suggesting its potential value for the treatment of end-stage liver diseases. |
| Hepatology |
A Revised Electronic Version of RUCAM for the Diagnosis of Drug Induced Liver Injury. RECAM is an evidenced based update that is at least as capable as RUCAM in diagnosing DILI compared to expert opinion but is better than RUCAM at the diagnostic extremes. RECAM's increased objectivity and clarity will improve precision, reliability and standardization of DILI diagnosis but further refinement and validation in other cohorts are needed. |
Compromised hepatic mitochondrial fatty acid oxidation and reduced markers of mitochondrial turnover in human NAFLD. These findings suggest that compromised hepatic fatty acid oxidation and mitochondrial turnover are intimately linked to increasing NAFLD severity in patients with obesity. |
Disrupted BRCA1-PALB2 Interaction Induces Tumor Immunosuppression and T-Lymphocyte Infiltration in Hepatocellular Carcinoma Through cGAS-STING Pathway. This study reveals that persistent DNA damage caused by a defective BRCA pathway induces tumor immunosuppression and T-lymphocyte infiltration in HCC through the cGAS-STING pathway, providing new insight into tumor immune microenvironment remodeling that may help improve HCC response to PD-1 antibody treatment. |
Nlrp3 activation causes spontaneous inflammation and fibrosis that mimics human NASH. These results define the single cell transcriptomes underlying hepatic inflammation and fibrosis precipitated by NLRP3 activation. Clinically, our data support the notion that NLRP3-induced mechanisms should be explored as therapeutic target in NASH-like inflammation. |
Notch-triggered maladaptation of liver sinusoidal endothelium aggravates nonalcoholic steatohepatitis through eNOS. Endothelial-specific Notch activation triggered LSEC maladaptation and exacerbated NASH phenotypes in an eNOS-dependent manner. Genetic and pharmacological inhibition of Notch signaling effectively restored LSEC homeostasis and ameliorated NASH progression. |
Progressive loss of HNF4a activity in chronic liver diseases in humans. In HCC, loss of HNF4a activity was associated with advanced disease, increased inflammatory changes, portal vein thrombosis and substantially lower survival. In conclusion, these data indicate that loss of HNF4a function is a common event in the pathogenesis of chronic liver diseases leading to HCC and is important from both diagnostic and therapeutic standpoints. |
Traf3 inactivation promotes the development of intrahepatic cholangiocarcinoma via NIK-mediated hepatocyte transdifferentiation. TRAF3 inactivation promotes ICC development via NIK-mediated hepatocyte transdifferentiation. Oncogenic TRAF3/NIK axis may be a potential new therapeutic target for ICC. |
| Inflamm Bowel Dis |
Caveolin-1 Alleviates Crohn's Disease-induced Intestinal Fibrosis by Inhibiting Fibroblasts Autophagy Through Modulating Sequestosome 1. Our data demonstrate that CAV1 deficiency induces fibroblast activation by indirectly regulating SQSTM1/p62 to promote fibroblast autophagy. CAV1 or SQSTM1/p62 may be potential therapeutic targets for intestinal fibrosis. |
Histologic Evaluation Using the Robarts Histopathology Index in Patients With Ulcerative Colitis in Deep Remission and the Association of Histologic Remission With Risk of Relapse. In patients with UC who achieved clinical and endoscopic remission, histologic remission was independently associated with a lower risk of clinical relapse. |
Inflammatory Bowel Disease Risk Variants Are Associated with an Increased Risk of Skin Cancer. The results of this study highlight shared genetic susceptibility across IBD and skin cancer, with increased risk of NMSC in those who carry risk variants in IRF4, PTPN22, CPEB4, and BACH2 and increased risk of MSC in those who carry a risk variant in IL2RA. |
| J Crohns Colitis |
Anti-TNF agents restrict adherent-invasive Escherichia coli replication within macrophages through modulation of chitinase 3-like 1 in patients with Crohn's disease. Anti-TNF agents are able to restrict replication of pathobiont, such as AIEC, within macrophages by modulating FLOT-1 and CHI3L1 expressions in CD patients. |
Combined histo-endoscopic remission but not endoscopic healing alone in ulcerative colitis is associated with a mucosal transcriptional profile resembling healthy mucosa. The rectosigmoid mucosa transcriptional profile of UC patients in histo-endoscopic remission resembles that of HC mucosa and confers a lower risk of relapse. These data support that the combination of histo-endoscopic remission could be the most appropriate definition of mucosal healing in UC. |
Detailed transcriptional landscape of peripheral blood points to increased neutrophil activation in treatment-naïve inflammatory bowel disease. Immune dysregulation seen in peripheral blood transcriptomes of treatment-naïve IBD patients is mainly driven by neutrophil activation. |
ECCO Position on harmonization of Crohn's disease mucosal histopathology. In line with these needs, the European Crohn's and Colitis Organisation [ECCO] assembled a consensus group with the objective of developing position statements on CD histology based on published evidence and expert consensus. There was agreement that definitions of histological remission should include absence of erosion, ulceration, and mucosal neutrophils; that the absence of neutrophilic inflammation is an appropriate histological target in CD; that CD histological scores, such as Global Histological Disease Activity Score, lack formal validation; and that histological scoring systems for ulcerative colitis, including the Geboes Score, Robarts Histopathology Index, and Nancy Histological Index, can be used for scoring intestinal biopsies in CD patients. |
Existing prediction models of disease course in pediatric Crohn's disease are poorly replicated in a prospective inception cohort. None of the three main predictive models in pediatric CD achieved sufficient accuracy, far from that reported in the original cohorts. This highlights the necessity of external validation in any prediction model prior to its implementation in clinical practice. |
The thiopurine tale: an unexpected journey. Important steps have been made in recent years to unravel its metabolism, mode of action and pharmacogenetics. Till today thiopurine (based) therapy remains an essential immunosuppressive approach in treating patients with inflammatory bowel disease. |
| Neurogastroenterol Motil |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Clin Gastroenterol Hepatol |
| Gastroenterology |
Genetic Variation in Sugar Metabolism Confers a Protective Metabolic Profile. Interestingly, such beneficial effects are not associated with reduced sucrose intake but are related to increased acetate production from sucrose catabolism by gut microbiota. While further investigations will be required to elucidate molecular mechanisms, this study raises an exciting possibility of targeting SI for therapeutic intervention of metabolic diseases. |
| Gut |
| Hepatology |
T Cells: Friends and Foes in NASH Pathogenesis and Hepatocarcinogenesis. We will illustrate the cellular cross talk with other immune cells, the regulatory networks or stimulatory effects of these interactions and the role of the metabolic microenvironment in influencing immune-cell functionality. Finally, we will present the pros and cons of the current therapeutic strategies against NAFLD-related HCC and delineate possible novel approaches for the future. |
The RSPO-LGR4/5-ZNRF3/RNF43 module in liver homeostasis, regeneration and disease. In this review article, we recapitulate the role of the RSPO-LGR4/5-ZNRF3/RNF43 module during liver development, homeostasis, metabolic zonation, regeneration and disease. We further discuss the controversy around LGR5 as a liver stem cell marker. |
Letters to the editors and authors’ replies
| Gastroenterology |
| Gut |
| Hepatology |
| J Hepatol |
all remaining publications eg case reports, images of the month, etc…
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Hepatology |
| Inflamm Bowel Dis |
| J Crohns Colitis |